WHAT TO EXPECT WHEN EMERGENCY
MEDICAL SERVICES ARRIVES

by Slade Griffiths, BS, MICT I/C, and Terri Griffiths, BSN, MICT/RN

Emergency Medical Services (EMS) responds to a variety of calls for help, from motor vehicle crashes and accidents to medical emergencies. The Centers for Disease Control reports that 15.7 million Americans, 5.9% of the population, have diabetes; and, because of its many effects on the body, a great number of these individuals will be seen by EMS or hospital emergency departments. Let's spend a few minutes talking about what to expect if you or your family calls "911" for EMS for medical assistance. That way we can make that moment a little less scary, and a little more understandable.

Initially developed in the 1970s to reduce the morbidity and mortality associated with sudden cardiac arrest or traumatic injury, EMS has greatly evolved over the years. In the 1990s, EMS providers are able to recognize and treat most any medical or traumatic condition while transporting a patient to the hospital. EMS services vary nationwide—some employ paramedics (advanced life support providers who can administer intravenous medications, monitor the heart...) and others staff EMTs (basic life support providers who may be able to administer limited oral medications). It can be sort of confusing as to what each level of provider can perform in the out-of-hospital setting. Regardless, all function under medical control via standing orders or direct contact with a physician, and all provide the best possible patient care.

The care you are provided by EMS is directly related to the level of the EMS provider. Paramedics will assess the patient=FEs blood glucose (via glucose meter or visual test strip if allowed in their locale) and administer glucose (if needed) or intravenous fluids. EMTs may treat the hypoglycemia with oral glucose or may administer intravenous fluids. All EMS providers are well versed in airway management, history taking and patient assessment.

EMS personnel are trained to be aggressive with patient care. They respond to a myriad of difficult situations and have little time to spend with each patient. As such, they may appear to be gruff or uncaring. Nothing could be further from the truth! They are typically able to transform chaos into calm. They typically are very direct with history questions. They are focused on providing the proper emergency care; please do not confuse this with an uncaring attitude. Know that they are providing the care because they truly enjoy helping others.

When you call for help, EMS will immediately respond, usually with an ambulance staffed with two or three personnel. Additionally, other first responders such as fire departments or law enforcement agencies may also respond to your location. Do not be surprised if five people arrive to help! Also, the use of lights and sirens for these responding agencies is directed by departmental policy, despite requests to minimize drawing attention.

These personnel will immediately begin caring for the ill or injured. Some of the activities may include:

History and Physical Examination

One technician will typically start asking pertinent medical questions which center on past medical history, current medications, allergies, physician's name and hospital choice, while the other will begin the examination and treatment. Specific questions may include when the patient ate last, when and what medications were last administered, if unusual stressors have been present (e.g., infections, stress, exercise) and what the last blood glucose level check revealed. They will also, most likely, ask other questions unrelated to the diabetic condition. Family members can help EMS by compiling a list or gathering all of the patient's information and medications. Keep a current list of medications (include the medication name, dose and administration frequency) and a complete past medical history. This will help ensure the necessary patient information is relayed to medical providers. This information should also be readily accessible (either in a wallet if the person is away from home, or with the medications if at home). Family members should also keep a copy. Medic-Alert bracelets, or similar devices, are a fantastic method of alerting medical personnel to important patient history.

Treatment

Treatment, as previously discussed, will vary according to EMS provider. The patient may receive oxygen, medications, ECG monitoring, fluid administration or a host of other interventions. If the patient is conscious, treatment options should be discussed with both the patient and family members.

Transport

EMS will generally transport to the hospital designated by the patient. If the patient is critical or unable to communicate his or her wishes, EMS will follow specific guidelines for transport. Most generally, EMS does not transport patients with the use of lights or sirens.

Prevention of an emergency is always best. Keep your blood sugars under control, and test often. However, be prepared for such an occurrence—that should help everyone involved. Talk to your doctor about what should happen if you need emergency medical assistance. We hope this brief explanation of EMS and how it functions will be useful if emergency care is needed. Know that the EMS providers truly care about you.

Slade Griffiths, BS, MICT I/C
Director of Allied Health
Cowley County Community College
Winfield, Kansas

Terri Griffiths, BSN, MICT/RN
Nursing Supervisor Charge Nurse
Riverside Hospital William Newton Memorial Hospital
Wichita, Kansas
Winfield, Kansas